Background: Unexplained recurrent spontaneous abortion (URSA) frustrates women of childbearing age profoundly, and effective therapies are particularly important.
Objective: To compare the efficacy of heparin combined with aspirin and aspirin alone for URSA.
Search strategy: Electronic databases (PubMed, Medline, Web of Science, Clinical key and Cochrane Library) were searched for relevant studies from database inception to August 2019.
Selection criteria: Studies of women of childbearing age with at least two consecutive abortions were included.
Data collection and analysis: Relevant items were extracted, tabulated, and subjected to STATA for data analysis. Study women were divided into group A (taking heparin plus aspirin) and group B (taking aspirin alone). The primary outcome was the rate of live birth.
Main results: Women from eight randomized controlled trials were included: 493 in group A and 501 in group B. The number of live births was significantly higher in group A (P=0.003). The result remained the same in subgroup analysis by presence of antiphospholipid antibodies. Among women who had a live birth, gestational age at delivery tended to be older in group B (P=0.054). No differences in birthweight or intrauterine growth restriction were observed. Adverse effects were sporadically reported.
Conclusion: Among women with URSA, heparin combined with aspirin increased the live birth rate as compared with aspirin alone. There was a beneficial tendency of taking aspirin-only to prolong gestation week.
Keywords: Aspirin; Heparin combined with aspirin; Meta-analysis; Pregnancy failure; Repeated abortion; Repeated fetal loss; Treatment; Unexplained recurrent spontaneous abortion.
© 2020 International Federation of Gynecology and Obstetrics.